Home
Up
Planning for Medicaid Eligibility

 

  

Overview of Options

 

 

OVERVIEW OF OPTIONS

FOR AFFORDING LONG-TERM CARE

 

 

bulletMedicaid eligibility is the focus of most long-term care planning, but Medicaid is not the only potential source of payment. Other possible sources for long-term care coverage include:

 

bullet Medicare -- But Medicare is of only limited benefit to individuals concerned with paying for long-term care in a nursing facility.

 
bulletFirst, Medicare coverage requires prior hospitalization for three or more consecutive days, not including the day of discharge.  Many elderly in need of long-term care for dementia-related problems will not first need to be hospitalized in an acute-care facility.

 
bulletSecond, Medicare coverage is not truly "long-term," since benefits are available for a maximum of 100 days of care.  Even during that period Medicare will pay the full cost of care only for the first 20 days. For the next 80 days the patient is responsible for a daily co-pay, with Medicare covering only the balance.  After 100 days, the patient has to pay the entire cost.

 
bulletThird, Medicare covers only skilled-nursing care provided during this 100-day period.  As a result, many residents in a long-term care facility will not be eligible for Medicare for any period, since their needs can be met with custodial care. 

 

 
bullet Private Financing -- From a practical planning viewpoint, paying for care, either delivered at home or at a nursing home facility, from the family's own funds may be necessary for some period of time prior to applying for Medicaid. This option will especially be recommended where the individual has gifted assets to family members within the "look-back" period (discussed in a section below).  

 

bullet Long-Term Care (Nursing Home) Insurance -- Long-term care insurance has become an additional option for persons whose assets are substantial enough to make it unlikely that they will ever become eligible for Medicaid, and for those who fear the limited quality of care that a government-provided program such as Medicaid will likely pay for in the future. (See the section on long-term care insurance below.)

 

PREVIOUS / NEXT

 

 

 

 

DISCLAIMER

Martin J. Hagan is licensed to practice law in the Commonwealth of Pennsylvania. This website is intended solely for informational use and is not intended to solicit clients. Likewise, any information contained in or obtained from this web site is for informational purposes only and is not intended to be used as legal advice.

IRS CIRCULAR 230 DISCLAIMER:   Pursuant to Treasury guidelines, any tax advice contained in this website (or any link from it) does not constitute a formal opinion. Accordingly, any tax advice contained in this website (or any link from it) is not intended or written to be used, and cannot be used by any taxpayer, for the purpose of avoiding penalties that may be asserted by the Internal Revenue Service. You should seek advice based on your particular circumstances from an independent tax advisor.

Send mail to mhagan@haganlaw.net  with questions or comments about this web site.

 

 

Copyright © 2012  Martin J. Hagan, One Gateway Center - 8 South; Pittsburgh, PA 15222-1435
Last Updated: 02/07/12